Battling depression

Been feeling flat the past few days.  Normally I keep it to myself; don't want to be a killjoy or burden.  My friend noticed it yesterday: "you really are down aren't you?" she noted.  She didn't try to problem-solve, just hung out with me at my place while I cooked for her and we watched some DVD's.  She gets depression too, so we didn't need to really talk about it.  I was just grateful she was there.

A counsellor from the mental health group I attended commented on my flat mood today too.  I was attending a quit smoking course being run for free there.  I wasn't trying to be glum, just couldn't inject enthusiasm into my verbal or facial expression.

I'm dreading the  nightly "how has your day been?" call from my Mum.  She doesn't handle me being flat very well; tends to wring her hands in despair or just get exasperated with me.  I can fake enthusiasm for a ten minute phonecall though; sometimes it's easier than trying to 'justify' being depressed.

That's just it: the need to justify, to reassure that it will pass, which it will.  I'm fortunate; my flat moods do tend to pass relatively quickly.  I've only felt like this since Tuesday, unlike other times when the mood has persisted for weeks or even months.  If it happened more frequently I'd be more proactive about trying to assist myself to   rise out of it, eg: walking, avoiding excess caffeine and smokes, trying not to isolate.....all that palava.
                                                                                                                                                                         On the plus side I have kept up with basic housework.
I haven't drank since Monday when I got obliterated on red wine (cask red....paint stripper).

I get out of bed in the morning by 8am most days.  I shower etc.  So things haven't really hit the skids yet.

Am seeing the clinical psychologist tomorrow.  Hope to get some things sorted.  This mood fucking sucks.  Out foul stench out!!!!!

Volunteering

I've been volunteering one or two mornings a week at a local charity which gives out free food to needy people who live in our district.  It operates out of a small office owned by a church, and has a trusty brigade of volunteers, mostly women in their 70's.  Needy locals get a referral from the citizens advice bureau and can turn up once a month.  There is a constant demand: today we were flat out.  I work out the back in the storeroom, filling orders and restocking the shelves.  We get our fresh food from the local Aldi supermarket who give us fruit and veg which is wilting but usable.  The rest comes from a charitable warehouse called Foodbank which operates in Dandenong; I'm not sure if what we get is free or is paid for by the church.  In any case, we are rarely without customers; today was no exception.

One client really struck me; she would have been about 25 and was nursing a young baby.  She had 6 kids to feed.  When I filled in her order I chucked in lots of extras that weren't on her 'shopping list'.  As people arrive they wait their turn then go into the office and have their needs assessed by another volunteer, who asks them which items they would like from a staple list that we generally have, although there's always anomalies due to variations in the stock provided from Foodbank.  I have to keep the office person abreast of what we have out the back and when we run out of an item.  It's fun, physical and rewarding; as I give the bags of goods to people in the waiting room they say thankyou and smile.  I love giving food away to people.  Our last customer today was a lady who hadn't been able to afford easter eggs for her kids; she spied some on the shelf behind me and asked if she could please have 2 chocolate bunnies; I gave her the biggest 2 I could find.  Even if she was scamming I didn't mind.

We get a few scammers coming in; people with multiple names and ID's who try and rort the system; or who lie about having kids when they don't have any. There's not much you can do about that.  I figure the majority are genuine, and there's probably an element of desperation in the scammers themselves.

My psychologist suggested I try out for a job at a supermarket doing shelf stacking or some mindless stress less activity: I know there'd be an element of stress in a supermarket, I've been there before.  But it's not a bad suggestion; I will try and pursue it with my employment counsellor, a new one whom I've yet to meet.  I had hoped she'd contact me this week but as yet no luck.  If I don't hear by Monday I'll email my old consultant (who got a promotion in the same organisation) to see what's up. In the meantime the volunteering is filling a void in my life and helping me feel like I'm being useful for a change.

Ever wondered what an appointment with a Psychiatrist is like????

Ok; for starters - it depends what country you reside in.

Secondly, a lot depends upon how rich you are, even if you are in an affluent country, and whether you have health insurance.

Thirdly, there are different sorts of psychiatrists: many are mostly medication tweakers; some engage in talking therapies such as CBT (cognitive behavioural therapy), DBT (dialectic behavioural therapy); others ask how your life has been since last you saw them.

Then there are the Psychotherapists: they can engage in hypnosis to uncover your subconscious or root feelings which govern many of your ongoing reactions to life, or they can get you to lie on a couch and ramble for an hour then they unemotionally reflect back what is at the core of your issues (eg: desire to return to the womb, to be taken care of, to refuse to grow up).

Finally......as I said first up: it depends what country you reside in.  These examples above are from my personal experiences with psychiatrists and the like from Melbourne Australia from 1995 to the present.  By no means is it a full (or even accurate) picture of what exists in Melbourne, let alone Australia or America (where to my perception a lot of people see a 'therapist' who seem to have relatively mild symptoms; not a good or bad thing, just an observation) or other countries around the world.  I can only tell you what I've experienced, so here 'tis.

The most common session with a psychiatrist goes like;

(1) Turn up on time, check in at reception, wait in the crowded waiting room between 15-45mins to be seen;

(2)  You greet him or her as "Dr. xyz"...they prefer that generally than to to be called by their first name; in turn they tend to call you by your full christian name, 

(3)  He searches for your file then sits in his chair with you opposite; he studies his notes from the previous couple of sessions and nods and says:  "Hmmhmm...ok.  So....how have you been?".  It is up to me to have salient points from the past few weeks since I last saw him; I generally think these through when I am in the waiting room.

The topics which get visited time and again are: sleep patterns (good/poor); diet and weight loss (required due to me stacking on weight since I hit 30 whilst on certain medications as do a lot of people due to the medications drastically increasing your appetite); exercise efforts (assists general and especially mental health, especially for people with mood disorders like bipolar, schizoaffective disorder and depression); alcohol usage/abuse (dual diagnosis/co-morbidity); whether I have isolated too much or made an effort to socialise; self-care (showering, dressing, cooking, cleaning); job issues (ability to cope when employed; efforts to jobseek when unemployed); family issues; distressing incidents; any achievements etc.

(4) Medication usually gets discussed; moreso when just starting a new one and it's side-effects; also when altering the level of dosage.  I had a previous psychiatrist describe his role as "having me on the least amount of medication possible whilst having me be mentally and physically as well as I can be".  That's a pretty decent aim in my book; the therapy or practical assistance side tends not to ever come from the doctor; that is what social workers, psychologists, outreach workers, drug and alcohol counsellor etc. are there for.  I'm lucky that my current psychologist (a clinical psychologist, although she doesn't administer mendication) writes a 6 month summary of our hourly sessions and sends them to my psychiatrist.  We joke that he never reads them, but I can't assume that.  I see my psychologist every 3-4 weeks, and we go into much the same as point (3), but also include past feelings and more depth.

(5) While my appointment says its for half an hour on the receipt I get when I pay at reception, I generally spend around 15-20mins with my current doctor.  The longest I've spent with a Psychiatrist is an hour-long session, and those were with the psychotherapists (which were short-lived).  A lot of Australian psychiatrists will see you only for half an hour, often less.  I pay $130 for my 15-20min glimpses, then get back $112 cash from Medicare; so my doctor isn't that unreasonable.

One thing about my doctor: he always seems rushed; he works at the adjoining private psychiatric hospital, and often dashes across the road to see a client .  He works six days a week, and is always available on-call.  With his European manner and accent he can seem very abrupt, cold, brusque and rude.  Yet I stick with him for his ability to manage my medication, and in spite of his manner I believe him to be a very ethical man.  He has my brain chemistry in his hands; I've trusted 2 other doctors before and they have got the medication part terribly, terribly wrong; so much so that I ended up in hospital twice because of their medication miscalculations.  I took what they said me to take and ended up very unwell.  Not so my current doctor, who has made some changes but always in the aim of helping me be as physically and mentally as well as I can be.  That in my eyes is a good Psychiatrist: I'm a type 2 diabetes risk, so losing weight just has to happen, no question.  I've been on the same anti-psychotic (olanzapine) for 3 years now.  There are newer antipsychotics around which are, as my Psych says "weight-neutral", but can have worse side-effects than the olanzapine, which I've thus far tolerated well, aside from getting the midnight munchies from time to time.  So hopefully we can make a medication breakthrough in terms of the hunger-pangs sometime in the near future.

So......yeah...sorry, I reverted to my current doctor instead of a "typical" session with a psychiatrist.   I guess all I can say is there is no typical session, other than the points I highlighted in bold in subsection (3) above.  I hasten to add that this has only been in my experience, although I have compared notes with some people I've met along the way who have seen psychiatrists and have found some similarities between their sessions and mine (not that we went into details).

One thing which inevitably irks me is when you've been to your session with the shrink, and someone (usually a well-meaning family member) says:  "So what did the Doctor have to say?".  I have tried educating them that it is mostly the doctor asking me questions, not the other way around.  I guess it highlights the lack of understanding of psych issues generally; that people assume its like a general medical condition where you describe your symptoms and get told a course of action of what to do (eg: fill this prescription; see this specialist; get some rest etc).

Unlike a general physician, I've never had a psychiatrist tell me what I should do, not in black and white, not as an absolute.  They might recommend things, but aside from taking my meds on time there's precious little orders.  The exception is if my drinking gets out of control or if I am in hospital; then he treats me like I'm a child.


But that's another story.

Would you Believe.........

I wasn't sure how many of you out there picked up on the ode to the 1960's comedy series "Get Smart" that I've made in the title of this blog.  I'm guessing there would have been a few, but didn't want to assume.  Maxwell Smart, agent 86 as brilliantly played by Don Adams, along with agent 99 (the wonderful Barbara Feldon) acted as my surrogate babysitter for much of my childhood.  In the 1970's my sister and I were latch-key kids; Dad had left Mum who was now out in the workforce.  There was no such thing as after-school programs for young kids then.  So we skipped our way home, found the housekey from where it was hidden on a nail behind the fencepost down the end of the driveway, and set about amusing ourselves.

This meant making the biggest glass of Milo and milk, along with a decent handful of sweet bisciuts (usually teddy bears as Mum wouldn't allow chocolate ones which were too expensive and were Bad For You) and plomping oneself in front of the teev for a solid diet of american re-runs of sit-coms from the 60's.  Staple diet of amusement included;

I Dream of Jeannie (sexist but worth watching for Dr Bellows' indignation)

The Brady Bunch (cheesy but always watchable; loved the Hawaiian episodes with the cursed 'tiki')

Bewitched (Endora was a goddess; an early gay icon, she looked like a Mardi Gras float entrant)

and of course...

Get Smart (Max was infuriating but the sight gags were great; Siegfried also used to make me chuckle).

While I have a degree of fondness for these shows I don't feel rose-eyed enough to purchase them on DVD, much less watch them on the new extra free-to-air digital channels.  I have perused them briefly on the digital channels and find them so very dated, sexist and not even funny.  Times change, huh?  Mind you I see some of what's on offer on our screen and just shake my head in disbelief; are we really in the 21st century when dross like "2 Broke Girls" still slimes its way across our screens?  

Anyway look I'm not about to holler the feminist howl and cry foul; it's more the moronic witless banter I dislike.  Even the newest episodes of Big Bang Theory seem to have lost their lustre over the past few months.  No wonder I listen to radio these days more than watching the box.

I watched a zombie DVD this afternoon: "Land of the Dead" by George A. Romero, the man responsible for the zombie classic "Dawn of the Dead".  It was an ok 2005 outing with Simon Baker as a passable hero; Dennis Hopper being strangely miscast as a corporate villain; but the real stars were the zombies, they were a hoot.  There's such an art to doing a real zombie-shuffle, I think.  The stiff legged style is one approach, although I noted one talented zombie doing a buckled-knee action which was suitably awkward too.  Anyway lots of brain and flesh-eating; good fodder for a rainy Tuesday afternoon whilst slowly sipping a glass of cask shiraz with the dog on my lap.

I have to limit my red wine consumption: have found out the hard way it is a bucket full of histamines, which doesn't block my nose; rather it makes my throat puff up and a bit hard to breathe.  I find if I have more than 3 small glasses I have to sleep with 3 chunky pillows in order not to choke.  Weird reaction.  Anyhow I shouldn't be drinking at all; have been battling this for the past month or so; a never-ending story.  Moderation is soooooooo hard.  I can manage it with most things, but not with cigarettes or alcohol.  Bummer.

Anyway this has weaved and ducked all around the joint, this post.  I'm tired.  It's time to feed the dog and watch the news.  Bye.